Autistic Burnout, Sensory Overload & Executive Function

An autistic client came to me because he is struggling to follow through on daily tasks after work. By evening he is exhausted and can’t get to the other things on his to-do list. He’s frustrated, and he sees it as an executive functioning problem. He believes a better calendar or smaller task steps would fix it.

Those tools can help. But there is more going on underneath.

Where he sees an executive functioning challenge, I see autistic burnout and a nervous system depleted by constant sensory demands. His depleted nervous system needs to be addressed before anything else.

What Is Autistic Burnout?

Autistic burnout is a syndrome thought to result from chronic life stress and a mismatch between expectations and abilities, without adequate supports. It’s marked by pervasive, long-term exhaustion (typically 3+ months), loss of function, and reduced tolerance to stimulation (Raymaker et al., 2020, p. 133).

What Constant Sensory Input Can Do to Capacity

Burnout has many contributors. I’m zooming in on the sensory piece, because sensory processing is a core part of what occupational therapists are trained to assess. 

Research suggests different things may be at play:

• Filtering: The thalamus helps filter out background input. Some research suggests this filtering may work differently in autistic brains, so background signals may be more intense

• Habituation: Autistic people may habituate more slowly, meaning sounds, lights, and textures don’t “fade into the background” the way they might for others. They keep feeling as prominent as they did at the start

• Detecting overwhelm: Studies suggest that autistic individuals may have decreased ability to detect when they are feeling overwhelmed (that ability to detect body signals is called interoception). This may be due to an already overloaded sensory signals- therefore body signals associated with overwhelm do not register as strongly

Over a full day, that adds up. By evening, there may be little capacity left for anything else. If this continues to happen day after day burnout can occur. 

How Occupational Therapy Helps

Occupational therapists are trained to understand how sensory demands affect a person’s ability to complete the tasks that matter to them, and to help individuals use evidence-based strategies to manage those demands. 

For my client, that means:

• Awareness of the environmental triggers
• Understanding what overwhelm feels like in the moment 
• Having built in recovery that is based on routine vs. body signals (since the body signals are not reliable)
• Understanding what breaks provides rest and recovery 
• Setting boundaries and purposefully “deleting” things off his plate to give himself time to recover

Burnout recovery isn’t quick, but it is possible when the support fits how your nervous system works 

If you’re struggling with follow-through, it may not be a planning problem. It may be a capacity problem, and that’s something we can work on.